Computer-assisted gap balancing technique improves outcome in total knee arthroplasty, compared with conventional measured resection technique

Pang, Hee Nee; Yeo, Seng-Jin; Chong, Hwei Chi; Chin, Pak Lin; Ong, Chin-Ann Johnny; Lo, Ngai-Nung

doi:10.1007/s00167-011-1483-3

Cited by 129 publications

(98 citation statements)

References 45 publications

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“…Other studies report revision rates of navigated TKAs: Hernández-Vaquero et al assessed 100 patients with a follow-up of eight years and detected similar revision rates between conventional and navigated techniques [18]. Harvie et al evaluated 71 patients and found no revisions after five years [19], Pang et al 140 patients and no revisions after two years [20], and Ishida 54 patients and one revision in each group after five years [21]. Lüring et al performed a matched-pair analysis of 100 patients and detected no revision after five to seven years [22].…”

Section: Discussionmentioning

confidence: 99%

Influence of computer navigation on TKA revision rates

Schnurr

Güdden

Eysel

et al. 2012

International Orthopaedics (SICOT)

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Purpose We performed this study to determine whether the use of imageless navigation reduces revision rates after total knee arthroplasty (TKA). Methods Data of 1,121 consecutive primary TKA with a follow-up of one to six years were retrospectively analysed. Following the conversion of the standard technique from conventional to navigated procedures, these data included the last 342 conventional and first 779 navigated procedures performed in our clinic. Demographic and perioperative covariates were recorded. All patients were asked by post to report instances of revisions. Results Data of 1,054 patients (94 %) were complete. Mean follow-up was 3.9 years for conventional and 2.4 years for navigated operations. Cumulative revision rate averaged 4.7 % for conventional and 2.3 % for navigated procedures. Cox's proportional hazard model was used to assess the effect of covariates on survival, resulting in significantly lower revision rates for older patients (p<0.001) and for the navigated technique (p00.012). The reduced revision rate for navigated operations was mainly caused by a significantly reduced rate of aseptic implant loosening (1.9 % vs. 0.1 %, p00.024). Conclusions Our study showed lower revision rates when computer navigation was used. However, due to the retrospective uncontrolled design, further prospective trials will be necessary to further evaluate this effect.

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Section: Discussionmentioning

confidence: 99%

Influence of computer navigation on TKA revision rates

Schnurr

Güdden

Eysel

et al. 2012

International Orthopaedics (SICOT)

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“…Another difficulty with patient-specific guides is that they do not take into account the effects of soft tissue balancing. The gap-balancing technique has been advocated over the measured resection technique in some studies, including navigation studies, in terms of less abnormal femoral component rotation and coronal instability and better functional outcome [8,10,17,24]. We used the gravity traction method, which uses gravity as a tension force for reproducing a rectangular flexion gap.…”

Section: Discussionmentioning

confidence: 99%

Is TKA Using Patient-specific Instruments Comparable to Conventional TKA? A Randomized Controlled Study of One System

Roh¹,

Kim

Lee

et al. 2013

Clinical Orthopaedics &Amp; Related Research

101

144

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Background Patient-specific CT-based instrumentation may reduce implant malpositioning and improve alignment in TKA. However, it is not known whether this innovation is an advance that benefits patients. Questions/purposes We evaluated (1) the precision of patient-specific TKA by comparing the incidence of outliers in postoperative alignment between TKAs using patientspecific instruments and TKAs using conventional instruments, and (2) the reliability of patient-specific instruments by intraoperatively investigating whether the surgery could be completed with patient-specific instruments alone.Methods In this randomized controlled trial, we compared patient-specific TKA instruments from one manufacturer (n = 50) with conventional TKA instruments (n = 50). Postoperative hip-knee-ankle angles, femoral component rotation, and coronal and sagittal alignments of each component were measured. The validity of the patient-specific instrument was examined using crosschecking procedures with conventional instruments during the surgeries. When the procedure could not be completed accurately with patient-specific instruments, the procedure was converted to TKA using conventional instruments, and the frequency of this occurrence was tallied.

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“…In addition, a decreased joint gap value during 90°to 135°of knee flexion showed an inverse correlation with the postoperative knee flexion angle because a larger tightness of the extensor mechanism including the PF joint leads to a poorer knee flexion angle [10]. On the other hand, other reports have concluded that there is no significant clinical difference between gap balancing technique and conventional measured resection technique [18,28]. In the future, further research on the relationship between gap asymmetry in UKA using spacer block technique and range of motion and clinical results should be conducted.…”

Section: Discussionmentioning

confidence: 88%

Evaluation of spacer block technique using tensor device in unicompartmental knee arthroplasty

Suzuki

Ryu

Kojima

et al. 2015

Arch Orthop Trauma Surg

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Computer-assisted gap balancing technique improves outcome in total knee arthroplasty, compared with conventional measured resection technique

Abstract: Computer-assisted gap balancing technique was able to achieve more precise soft tissue balance and restoration of limb alignment with better knee scores as compared to the conventional measured resection technique in total knee arthroplasty.

Cited by 129 publications

References 45 publications

Influence of computer navigation on TKA revision rates

Influence of computer navigation on TKA revision rates

Is TKA Using Patient-specific Instruments Comparable to Conventional TKA? A Randomized Controlled Study of One System

Evaluation of spacer block technique using tensor device in unicompartmental knee arthroplasty

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